Nursing Elites

1. A nurse is providing dietary teaching for a client who has a burn injury and adheres to a vegan diet. The nurse should recommend which of the following foods as the best source of protein to promote wound healing?

• A. One cup of brown rice
• B. One cup of orange juice
• C. One cup of pureed avocado
• D. One cup of lentils

Correct answer: D

Rationale: Lentils are an excellent source of plant-based protein, essential for wound healing in a vegan diet. Brown rice, orange juice, and pureed avocado are not protein-rich foods like lentils and would not provide sufficient protein for wound healing in this scenario.

2. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

3. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

4. Clients may benefit from slightly higher fat intakes than are normally recommended if they have:

• A. congestive heart failure
• B. cerebrovascular accident
• C. peripheral vascular disease
• D. chronic obstructive pulmonary disease

Correct answer: D

Rationale: In chronic obstructive pulmonary disease (COPD), higher fat intake can be beneficial because it provides more calories with less respiratory burden compared to carbohydrates. Choices A, B, and C are incorrect because congestive heart failure, cerebrovascular accident, and peripheral vascular disease do not specifically benefit from higher fat intakes as in COPD.

5. What does a QRS Complex represent in an ECG reading?

• A. Atrial depolarization
• B. Ventricular repolarization
• C. Ventricular depolarization
• D. End of ventricular depolarization

Correct answer: C

Rationale: The QRS Complex in an ECG reading represents ventricular depolarization, which is the process of the heart's ventricles preparing to contract by changing the electrical charge in the cell, hence choice 'C' is the correct answer. Choice 'A' is incorrect because atrial depolarization is represented by the P wave in an ECG reading, not the QRS Complex. Choice 'B' is incorrect as ventricular repolarization is depicted by the T wave, not the QRS Complex. Finally, choice 'D' is also incorrect because the QRS Complex is not the end of ventricular depolarization, but the process itself.

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